NHS Future Forum

Valerie Vaz Excerpts

Tuesday 14th June 2011 Commons Chamber

[Mr Lansley]

Yes, my hon. Friend makes an important point. If we had listened to the Labour party last year, we would have cut the NHS and would not have increased the resources going into it. The £20 billion efficiency savings required to respond to demand and cost would have been £30 billion, which would have put an unsupportable degree of pressure on the NHS. As it is, we are giving the NHS not only resources but the opportunity to deliver improving care.

[Valerie Vaz (Walsall South) (Lab)]

After the White Paper was published in July last year, 6,000 representations were received from health professionals and from the Select Committee on Health asking the Secretary of State to think again about breaking up the NHS, so this “listening exercise” has been a waste of public money. Either the Secretary of State was wrong then, or he is wrong now. Which is it?

[Mr Lansley]

I am afraid I have to say that that was all nonsense. As the hon. Lady knows, we responded positively to the consultation last year and made changes then. However, as the details of the Bill have been emerging, people have been trying to work out how they will make it all work in the future. They have been saying, “We want to set out in the legislation precisely how it will work.” There is no better way of making that process effective than talking to people in the NHS, engaging with them, listening to them, and then implementing the changes.

Oral Answers to Questions

Valerie Vaz Excerpts

Tuesday 7th June 2011 Commons Chamber

[Mr Lansley]

I am sure that my hon. Friend is aware of the evidence—for example, in reports published by the London School of Economics and by Imperial college, London—on this country’s experience of the Labour party’s implementation of choice in elective care and the impact that had on the quality of services. What is clear from that evidence is that where there was an NHS price—a tariff structure—the more competitive areas of the country secured greater improvements in quality.

[Valerie Vaz (Walsall South) (Lab)]

I thank the Secretary of State for writing to me on 12 May about the listening exercise and its cost, although he could not quantify that. Now that the listening exercise is over, can he say how much the cost to the public purse has been?

[Mr Lansley]

I will, by all means, write again to the hon. Lady. The cost is not dramatic. Many organisations and people across the NHS have participated, giving freely of their time. Some 8,000 people have participated in the listening exercise events, of which there were more than 250. This has been immensely valuable; its value far exceeds any costs involved.

Future of the NHS

Valerie Vaz Excerpts

Monday 9th May 2011 Commons Chamber

[Valerie Vaz (Walsall South) (Lab)]

It is always a pleasure to follow the hon. Member for Totnes (Dr Wollaston) and to serve with her on the Select Committee on Health.

I welcome this debate, which is the first chance that the House has had to debate the NHS after the pause—the listening, reflecting and engaging exercise—since Second Reading of the Health and Social Care Bill. Something about this debate made me think of the words of The Beatles song “Hello, Goodbye”. Madam Deputy Speaker, you can imagine the discussion in No. 10 between the Secretary of State for Health and the Prime Minister: “You say stop, I say go. You say, ‘Why?’ I say, ‘I don’t know.’” I promise it sounds better when sung. We can see now why The Daily Telegraph said this Saturday that the Secretary of State was to get first aid from the No. 10 spin doctors.

It is right that the Government should take on board the voices in this House and outside—those of the experts, the patients, our constituents—not in reselling their proposals, but in fundamentally changing them. I wish to cover three main areas: accountability, costs and other concerns. On accountability, as a member of the Health Committee, which is so ably chaired by the right hon. Member for Charnwood (Mr Dorrell), we have heard evidence from expert after expert—from the BMA, which I promise was not whingeing, to GPs, nurses and public health clinicians—all of whom expressed concerns about the lack of detail on the ideas in the White Paper. Matters did not become much clearer even on Second Reading.

Our latest report, “Commissioning: further issues”, published on 5 April, said that there should be no doubt that the Secretary of State has ultimate responsibility, but that is not clear from the Bill. We have concerns about accountability and the governance arrangements for the consortia that will be responsible for £60 billion of public money, but that issue is not clear in the Bill. There are concerns that private and voluntary providers will not be covered by the Freedom of Information Act 2000, which is not dealt with in the Bill either. Concerns remain about conflicts of interest in respect of GPs who are commissioners and providers, but that is not clear in the Bill.

Some PCTs were working with clinicians to provide a more integrated service. A more evolutionary and cost-effective approach would be to remove the non-executive directors of the PCT boards and replace them with GPs. That would have been not a top-down reorganisation, but a progressive and less disruptive approach.

I am staggered by the uncertainty surrounding how much this reorganisation will cost the taxpayer. The proposals in the White Paper were neither costed nor explained, and the spending is not committed, so it must come out of revenue. Professor Kieran Walshe, of Manchester Business School, put the cost at £2 billion to £3 billion, but the Government’s figure is £1.4 billion. The redundancy costs alone amount to £852 million. Sir David Nicholson said that the running-cost envelope was £5.1 billion for the running of the current service and the development of the consortia. In an written parliamentary answer to me, the Minister said that the spend and operational arrangements of pathfinder consortia are not being monitored. That smacks of fiscal incompetence and a Department that has lost control of its budget. It is so out of control that the head of Monitor wrote to foundation trusts, telling them that the NHS must find savings of 6.5% rather than 4%. That is an extra £1.1 billion on top of the savings demanded by the Department.

Members will be interested to know that the head of Monitor compared the NHS under the Government’s proposals to privatised utilities. Does Ofgem have trouble regulating the utilities? It was ineffective in dealing with companies’ unfair pricing practices and companies that made large profits during the recent severe weather.

[Lilian Greenwood (Nottingham South) (Lab)]

Does my hon. Friend agree that the Government’s plan to abolish the cap on income from private patients is a real concern when hospitals are starved of cash, because it could result in them putting private, fee-paying patients ahead of NHS patients?

[Valerie Vaz]

I absolutely agree with my hon. Friend.

We were told by Sir David Nicolson that very little work has been done on what will happen in 2013-14. Just for the record, the UK had the second-lowest debt in the G7 in 2007-08, before the global financial crisis. Which Government are out of control with their spending?

Finally, there are many unanswered questions. I have tried to obtain the legal advice on whether EU competition law applies to the provisions of the Bill from the Secretary of State, but apparently, it is in the public interest not to disclose that to the public. However, in a recent article in the British Medical Journal, Rupert Dunbar-Rees, a GP, and Robert McGough, a solicitor, say that

“the technical argument reinforces the logical argument that the reforms further open up the NHS to EU competition law.”

Who will account for the training of doctors, and indeed health care professionals? That cannot be left at a local level. In A and E, an increased percentage of patients wait more than four hours, the maternity service in Maidstone has been closed despite GP opposition—

[Madam Deputy Speaker (Dawn Primarolo)]

Order. I am very sorry to interrupt the hon. Lady, but the clock is not correct. If she is following that, she will not know that she does not have that much time left—the clock stopped and did not start again. I would advise her to take about another minute and a half only.

[Valerie Vaz]

At Barts specialist regional cancer care unit, 20% of staff have been cut in two weeks.

An Ipsos MORI poll found that 71% agree that the NHS is the best in the world and that 72% express satisfaction with the NHS, but that was published by the Department only under pressure.

Finally, there have been 6,000 responses to the White Paper. The people of England have given their proposals, but they have not given their verdict on the Bill. They want the Prime Minister to keep his promise. If he does not do so, they will be ready to give their verdict at the next general election.

[Several hon. Members]

rose—

Oral Answers to Questions

Valerie Vaz Excerpts

Tuesday 26th April 2011 Commons Chamber

[Mr Lansley]

That, indeed, will be one of the areas on which the quality and outcomes framework for individual GP practices will focus. In addition, however, through the commissioning outcomes framework for the NHS as a whole, one area in which we want to see continuing improvement in quality is patient experience and outcomes as reported by patients. GPs and their clinical colleagues will therefore be incentivised continuously to improve quality.

[Valerie Vaz (Walsall South) (Lab)]

Can the Secretary of State tell us how much this consultation exercise is costing the public purse?

[Mr Lansley]

No, I cannot, but I will write to the hon. Lady.

NHS Reform

Valerie Vaz Excerpts

Monday 4th April 2011 Commons Chamber

[Mr Lansley]

Yes, I agree. Indeed, in north-east Essex, the consortium under Dr Shane Gordon’s leadership is doing exactly that. I personally think that leadership and listening are not mutually exclusive, and we are going to continue to do both.

[Valerie Vaz (Walsall South) (Lab)]

In the spirit of openness, will the Secretary of State please place in the House of Commons Library a copy of the legal advice on whether EU competition law will apply to the provisions in the Bill?

[Mr Lansley]

The hon. Lady should know, as a member of the Health Select Committee, that I wrote to the Chair of the Committee just last week and set out the position very fully. The Bill does not extend the scope or application of competition law at all.

Oral Answers to Questions

Valerie Vaz Excerpts

Tuesday 8th March 2011 Commons Chamber

[Mr Lansley]

Local attention, through the public health responsibilities that currently lie with PCTs, but which in future will lie with local authorities, is a means by which we can improve health and the health of some of the groups most at risk of HIV. We have a number of pilot schemes that my hon. Friend might know about and that we are currently assessing, which have looked at opportunistic HIV screening for the many people who are currently undiagnosed with HIV. That is encouraging, and we might well be able to follow up on it.

[Valerie Vaz (Walsall South) (Lab)]

T10. Given that the chief medical officer does not have a background in public health, and despite the existence of Public Health England, should the Secretary of State not ensure that there is a public health expert on the national commissioning board, because that is where all the power lies?

[Mr Lansley]

I am surprised, because the hon. Lady is on the Select Committee on Health and should know that responsibility for public health will lie both with Public Health England, inside the Department of Health, and with local authorities. The NHS commissioning board will have a responsibility for prevention, but the population health responsibility will lie with Public Health England, and I have absolute confidence that Dame Sally Davies, the newly appointed chief medical officer, will be a leader in public health delivery, through Public Health England.

Swine Flu

Valerie Vaz Excerpts

Monday 10th January 2011 Commons Chamber

[Mr Lansley]

I am grateful to my hon. Friend for that question. His local hospital, the Glenfield in Leicester, leads on specialised ECMO bed services. In this country, we have increased the number of ECMO beds; we have more per head of population than any of the developed health economies, including the United States. As for treatments and vaccinations, I continue to rest upon the scientific and expert advice. Indeed, I hope that patients will consult their clinicians about their treatments.

[Valerie Vaz (Walsall South) (Lab)]

Will the Secretary of State say whether he took the decision to delay the advertising campaign and, if so, when?

Oral Answers to Questions

Valerie Vaz Excerpts

Tuesday 2nd November 2010 Commons Chamber

[Mr Lansley]

I am grateful to my hon. Friend. He knows that the criteria that I set out, which were repeated earlier during questions, must be applied, not only to the strategies that were previously presented, but to potential new strategies that Barnet and Chase Farm hospitals might wish to present, in order to ensure that GP commissioning intentions, future patient choice and public views are properly reflected.

[Valerie Vaz (Walsall South) (Lab)]

Many of my constituents are being offered the swine flu vaccine in combination with the seasonal flu vaccine. Will the Secretary of State ensure that they have the choice to have those vaccines separately?

[Mr Lansley]

The hon. Lady will forgive me, but I do not propose to make that available, as it would be a great deal more expensive. Each year, and on an international basis, the World Health Organisation advises on what the seasonal flu vaccine should consist of, and it almost always consists of the three most likely strains combined together into one vaccine.

Contaminated Blood and Blood Products

Valerie Vaz Excerpts

Thursday 14th October 2010 Commons Chamber

[Valerie Vaz (Walsall South) (Lab)]

It is always a pleasure to follow the hon. Member for Dartford (Gareth Johnson).

My hon. Friend the Member for Liverpool, Walton (Steve Rotheram) paid tribute to the campaigners by wearing a black tie. I am in rather a bright outfit for this occasion because of my own tribute to the breast cancer care campaign.

I congratulate my hon. Friend the Member for Coventry North West (Mr Robinson) on initiating this debate and I support his motion. In the words of Lord Winston, this is the “worst treatment disaster” in the history of the UK. Not only is it a human tragedy, but it is grossly unjust. My constituent Valerie Moule is widowed because, through no fault of her own or of her husband, the blood that he was given as a haemophiliac was contaminated by HIV. Ivan Moule was one of the first people to die from contaminated blood, in 1989. This is an unimaginable injustice. Ivan Moule innocently received blood as a treatment without knowing that it was killing him.

Injustice in any part of life has to be corrected and someone has to take responsibility when things go wrong—

[Mr Tom Clarke]

My hon. Friend has outlined some of the big issues that we are debating. Does she agree that one of the most unacceptable aspects of this situation is how widows have been treated?

--- Later in debate ---

[Valerie Vaz]

I agree with my right hon. Friend, and when I was contacted by Mrs Moule she very calmly and quietly encouraged me to take part in this debate.

When things go wrong, someone has to take responsibility, and that is the cornerstone of a civilised society. Despite their bereavement and illnesses, the determined campaigners, who are sitting in the Public Gallery wearing their armbands, established an independent inquiry paid for by private means. Not only do they have truth on their side, but—since April 2010—they have had the law on their side. In the Republic of Ireland, a full financial scheme is in place, with a compensation scheme based on civil law principles, but that is not mirrored in this country.

Haemophiliacs began dying of AIDS in the early 1980s. Some 2,000 people have already died having been infected by HIV. In my view, the Archer inquiry made significant recommendations that should all be implemented. It was cost-effective at the time to buy blood from other countries that was unscreened and, if we are not careful, that could happen again if commercial, cost-cutting considerations are brought into an area where they do not belong. As the Archer report says, commercial priorities should never override the interests of public health. This is a matter of public importance and public interest.

Proper financial relief should be paid to those who were infected. As a nation, we should apologise to those families who have suffered. We also need a commitment that blood will be screened and that blood from imported or unknown sources will not be used. We owe that to those who have died, like Ivan Moule, and to the living who cared for them, like Valerie Moule. I urge hon. Members to do the right thing and support the motion.

Oral Answers to Questions

Valerie Vaz Excerpts

Tuesday 7th September 2010 Commons Chamber

[Mr Lansley]

I am grateful to my hon. Friend. Many people are concerned about their experience of a postcode lottery and access to new cancer drugs. Indeed, there is not just a postcode lottery but an international lottery, with patients in this country not getting access through the NHS to new cancer drugs while patients in other countries do get access to those drugs in the same clinical circumstances. That is why we will not only establish the cancer drugs fund next year, but, this year, we have found £50 million by making savings on management and marketing costs to enable new cancer drugs to be made available, at a regional level across England, where they are not funded locally.

[Valerie Vaz (Walsall South) (Lab)]

Has the Secretary of State had any discussions with the National Institute for Health and Clinical Excellence about the fund, and is it cash-limited?

[Mr Lansley]

Yes, I did have discussions with NICE. The interim measure this year is indeed cash-limited—£50 million is available between October and the end of March.